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				logo
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				<p style="font-size:20px; font-weight:bold;">CASH ADVANCE LIQUIDATION FORM</p>
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			<td>Name:</td>
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			<td>DV No/s:</td>
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			<td>Date:</td>
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			<td>Period Covered:</td>
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			<td>Department:</td>
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			<td>Amount of Cash Advance:</td>
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			<td>Noted by:</td>
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			<td style="text-align:center; font-size:10px">Signature Over Printed Name</td>
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			<td>Reviewed by:</td>
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